Azathioprine-induced alopecia: a rare adverse event, early marker of myelotoxicity.

Though not exempt from adverse events, azathioprine (AZA) is an inexpensive and effective drug in the induction and maintenance treatment of patients with inflammatory bowel disease. We present the case of a 20-year-old female patient with left-side ulcerative colitis in whom AZA was started at a dose of 1.5 mg/kg/day due to dependence on corticoids (thiopurine methyltransferase activity: 14.9 U/mL). Two weeks after starting treatment she began to report excessive hair loss, resulting in an almost complete loss of scalp hair.

Debut de enfermedad inflamatoria intestinal secundaria a tratamiento con ixekizumab en paciente con psoriasis moderada de difícil manejo / Debut Of Inflammatory Bowel Disease Associated To Ixekizumab In Patient With Moderate, Difficult -To-Manage Psoriasis

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Terapia incisional endoscópica como alternativa terapéutica en estenosis esofágica anastomótica refractaria a tratamiento convencional / Incisional endoscopic therapy as a therapeutic alternative in esophageal anastomotic strictures refractory to conventional treatment

Las estenosis esofágicas anastomóticas son una causa no desdeñable de estenosis benigna y disfagia secundaria. Cabe destacar que son estenosis a menudo complejas, con un gran componente isquémico-fibrótico y, por tanto, difíciles de tratar por su recurrencia a pesar de dilatación endoscópica. En este tipo de pacientes, aparece como alternativa terapéutica la terapia incisional endoscópica, que permite eliminar el anillo estenótico, con un buen perfil de eficacia y seguridad. Presentamos el caso de un paciente con estenosis esofágica postquirúrgica refractaria a tratamiento con dilatación y prótesis endoscópica, tratado finalmente de forma satisfactoria con terapia incisional

Esophageal anastomotic strictures are a non-negligible cause of benign strictures and secondary dysphagia. It should be noted that these are often complex strictures, with a large ischemic-fibrotic component. Thus, they are difficult to treat due to their recurrence, despite endoscopic dilation. Endoscopic incisional therapy appears as a therapeutic alternative in this type of patient, which allows the elimination of the stenotic ring, with a good efficacy and safety profile. We present the case of a patient with postoperative esophageal strictures refractory to treatment with dilation and endoscopic prosthesis, who was finally satisfactorily treated with incisional therapy

Incisional endoscopic therapy as a therapeutic alternative in esophageal anastomotic strictures refractory to conventional treatment.

Esophageal anastomotic strictures are a non-negligible cause of benign strictures and secondary dysphagia. It should be noted that these are often complex strictures, with a large ischemic-fibrotic component. Thus, they are difficult to treat due to their recurrence, despite endoscopic dilation. Endoscopic incisional therapy appears as a therapeutic alternative in this type of patient, which allows the elimination of the stenotic ring, with a good efficacy and safety profile. We present the case of a patient with postoperative esophageal strictures refractory to treatment with dilation and endoscopic prosthesis, who was finally satisfactorily treated with incisional therapy.

Tuberculosis intestinal: importancia y dificultad del diagnóstico diferencial con enfermedad de Crohn / Intestinal tuberculosis and Crohn's disease: the importance and difficulty of a differential diagnosis

La tuberculosis (TBC) es la infección más prevalente del mundo y afecta a un tercio de la población mundial, predominantemente a países subdesarrollados, representando la TBC intestinal la sexta causa en frecuencia de afectación tuberculosa extrapulmonar. La enfermedad de Crohn (EC) es una enfermedad inflamatoria crónica intestinal que surge de la interacción de factores inmunológicos, ambientales y genéticos. El diagnóstico diferencial entre TBC intestinal y EC puede resultar un reto, sobre todo en pacientes inmunodeprimidos y en aquellos procedentes de áreas endémicas de TBC, debido a los cambios en la epidemiología de ambas patologías. Además, tanto la TBC intestinal como la EC tienen predilección por la región ileocecal y suelen presentar hallazgos clínicos, radiológicos y endoscópicos muy similares. El diagnóstico y tratamiento incorrectos podrían conllevar una elevada morbimortalidad, por lo que es necesario un alto índice de sospecha así como conocer algunas características que nos ayuden a diferenciar ambas enfermedades

Tuberculosis (TB) is the most prevalent infection worldwide and affects one third of the population, predominantly in developing countries. Intestinal TB (ITB) is the sixth most frequent extra-pulmonary TB infection. Crohn's disease (CD) is a chronic inflammatory bowel disease that arises from the interaction of immunological, environmental and genetic factors. Due to changes in the epidemiology of both diseases, distinguishing CD from ITB is a challenge, particularly in immunocompromised patients and those from areas where TB is endemic. Furthermore, both TB and CD have a predilection for the ileocecal area. In addition, they share very similar clinical, radiological and endoscopic findings. An incorrect diagnosis and treatment may increase morbidity and mortality. Thus, a great degree of caution is required as well as a familiarity with certain characteristics of the diseases, which will aid the differentiation between the two diseases

Intestinal tuberculosis and Crohn's disease: the importance and difficulty of a differential diagnosis.

Tuberculosis (TB) is the most prevalent infection worldwide and affects one third of the population, predominantly in developing countries. Intestinal TB (ITB) is the sixth most frequent extra-pulmonary TB infection. Crohn's disease (CD) is a chronic inflammatory bowel disease that arises from the interaction of immunological, environmental and genetic factors. Due to changes in the epidemiology of both diseases, distinguishing CD from ITB is a challenge, particularly in immunocompromised patients and those from areas where TB is endemic. Furthermore, both TB and CD have a predilection for the ileocecal area. In addition, they share very similar clinical, radiological and endoscopic findings. An incorrect diagnosis and treatment may increase morbidity and mortality. Thus, a great degree of caution is required as well as a familiarity with certain characteristics of the diseases, which will aid the differentiation between the two diseases.